A chemical splash in a child's eye: the first sixty seconds
If this is happening now, go to the tap and read the rest afterwards. Rinsing is not what you do while waiting for help. It is the treatment, and the clock started when the splash did.
- Rinse immediately, before phoning anyone and before getting in the car. The instruction given to doctors is irrigate first, then refer.
- Use clean water that is not hot, from a tap, a shower or a bottle, with a gentle flow, and hold the eyelids open or the water does nothing.
- Keep rinsing for at least twenty minutes by a clock, and do not stop early because the crying stopped or the eye looks normal.
- Nothing else goes in the eye. No milk, no oil, no drops, and nothing chosen to neutralise an acid or an alkali.
- Take the container or a photograph of the label to the emergency department. What was in it changes the treatment.
Most of the chemical splashes I see in children happened at about knee height, in the middle of an ordinary afternoon, while an adult was in the room. A spray bottle of bathroom cleaner left on the floor. A detergent capsule squeezed at face level because it looked like a sweet. A tube of glue picked up from a table edge. Nobody was careless. Toddlers are simply the right height for it.
This article is about the next minute, not about how it happened. If you are reading it with a crying child in your arms right now, stop reading and go to the tap. Everything below can wait twenty minutes. Your child's eye cannot.
My child got something in his eye, what do I do first?
Rinse. Not phone, not photograph the bottle, not look up the ingredients, not put shoes on. Get clean water running over the eye immediately, and keep it running. Every other useful thing you are about to do can be done while the water is running or afterwards.
This is the one piece of eye first aid where speed genuinely changes the outcome, and it is the one parents most often get in the wrong order. The instruction given to doctors is the same instruction I am giving you, in the same sequence: irrigate first, then refer. A chemical sitting on the surface of an eye goes on doing damage for as long as it sits there, so the water is not a comfort measure while you wait for help. It is the treatment.
How do I hold a struggling toddler under running water?
Badly, and it still works. Nobody manages this elegantly, and a technique that gets water into a furious child's eye for twenty minutes beats a perfect one you cannot sustain. If there is another adult in the house, call them now, because this is a two person job and one of you will be doing nothing but holding.
What to use: clean water that is not hot. A tap, a shower, or bottled water if you are not at home. Keep the flow gentle rather than forceful, because a strong jet hurts and makes the next nineteen minutes harder. A kitchen tap with a child lying along the counter, head over the sink and the affected eye lower than the other one, works well, and so does a slow shower run over the forehead with the child on a lap. Keeping the splashed eye lower than the other one keeps the run off away from the eye that was not splashed.
The part that decides whether this works is holding the eyelids apart. A child in pain will clamp them shut, and water on a closed lid is doing nothing. Use your thumb and finger against the bone above and below the eye, not against the eyeball, and hold the lids open while the water runs. If you have ever wrestled drops into this child before, use the same hold, and the positions that work for eye drops work here too.
How long do I rinse for?
At least twenty minutes, by a clock, and longer if help has not arrived. Set a timer on your phone the moment the water starts. Twenty minutes is far longer than it feels, and almost every parent who tells me they rinsed thoroughly has in fact rinsed for two or three.
Do not stop early because your child has stopped crying. Pain settling is not the same as the chemical being gone, and with some substances a quiet eye is exactly the point at which a parent relaxes too soon. Do not stop early because the eye looks normal either. You cannot see a chemical injury to the clear window of the eye by looking at it across a bathroom.
Keep rinsing while you wait for help, and keep rinsing on the way if the car allows it. A wet towel soaked and re-soaked, held over an open eye in the back seat, is not as good as a tap and is a great deal better than nothing.
Should I use saline, or milk, or something to neutralise it?
No. Use whatever clean water you can reach in the next ten seconds. Do not spend two minutes hunting for the saline in the first aid box, because those two minutes cost more than the saline gains. There is nothing wrong with sterile saline if it is already in your hand, and there is a great deal wrong with delay.
Nothing else goes in. Not milk, not breast milk, not oil, not toothpaste, not the eye drops in the fridge from last year, and above all nothing chosen to cancel out an acid or an alkali. Neutralising is not a thing to attempt at home. A second chemical in an injured eye is simply a second chemical injury, and it delays the only thing that helps.
Do not let your child rub, which is harder to prevent than it sounds, because rubbing is the automatic response to almost anything that stings and rubbing grinds whatever is there across the surface. Hold the hands if you must. If your child wears contact lenses, they come out, and they stay out until an eye doctor says otherwise.
His eye looks fine now, does he still need to be seen?
Yes. A strong household chemical in a child's eye is an emergency department visit, not a clinic appointment and not a wait and see, even when the eye is white and the child is back to normal. Bleach and oven cleaner are the two the NHS names first. Laundry capsules and household cleaning sprays sit on the Academy of Ophthalmology's list of what actually burns children's eyes at home, and so does anything you would not want on your own skin.
Take the container with you, or a clear photograph of the label. What was in it changes what is done at the hospital, and a parent who arrives able to say exactly which product it was gets a faster and better decision than one who says it was a blue cleaning spray. Be ready to say when it happened, how long you rinsed, and which eye.
Some things make it more urgent still, and they are worth knowing before you need them: severe pain, any change in your child's sight, light suddenly hurting, a headache, vomiting after the injury, an eye that will not open or will not move, or blood or pus coming from the eye. And do not drive yourself with an injured child in the car if there is any other way. Ask someone else to drive, or call for an ambulance, and keep rinsing.
What if it was not a chemical, but something that hit or cut the eye?
Then the rule reverses, and this is the single most useful thing on this page. Water is the first move for a chemical splash and the wrong move for an eye that has been cut or pierced. Any article that gives you one rule for eye injuries is wrong.
If something sharp has gone into the eye, or something has struck it at speed, do not rinse it, do not press on it, and do not pull anything out of it, however small the object looks. Cover the eye loosely with something rigid, a clean plastic or paper cup taped over the socket is the classic improvisation, and get to an emergency department. No painkillers containing aspirin or ibuprofen on the way. For a blunt knock with no cut, a light cold compress is reasonable, and any pain, any change in vision or any odd-looking pupil still means being seen.
Prevention is a longer conversation and it belongs elsewhere: what to move out of reach around the house covers the cupboards, the capsules and the glue, and the festival version covers the rest of the year. Read one of them on a calm evening. Tonight, if this is tonight, just keep the water running.
- A strong household chemical such as bleach or oven cleaner has gone into the eye, even if the eye now looks completely normal.
- There is severe pain, any change in your child's sight, or light has suddenly become painful.
- Your child has a headache, or is vomiting, after the injury.
- The eye will not open, will not move, or there is blood or pus coming from it.
- Something sharp has pierced the eye or hit it at speed. Do not rinse that one, do not press, and do not remove anything.
Common questions
My child got detergent in his eye, what do I do first?
How long should I rinse for?
Should I use saline instead of tap water?
Can I use milk or something to neutralise the chemical?
His eye looks fine now, does he still need to be seen?
What should I bring with me?
Do I take him to the clinic or straight to the hospital?
Is the advice the same if something hit or cut his eye?
- NHS · Eye injuries, including how to wash the eye and when to seek emergency care · www.nhs.uk
- Moorfields Eye Hospital · Chemical injury, children's eye conditions management · www.moorfields.nhs.uk
- NHS · Burns and scalds, including chemical burns · www.nhs.uk
- AAPOS · Eye injury and safety · aapos.org
- American Academy of Ophthalmology · Recognising and treating eye injuries · www.aao.org
- American Academy of Ophthalmology · Preventing eye injuries in the home · www.aao.org
- American Academy of Ophthalmology · Eye injuries from laundry packets on the rise · www.aao.org